The must-read stories and debate in health policy and leadership.

One of the big unknowns for the new NHS legislation is what role provider collaboratives will play in each integrated care system.

NHS England has suggested there could be some room for local flexibility, which means we could see a range of different set-ups around the country.

One region that views itself as a leader on such matters is Greater Manchester, and its provider collaborative looks set to play a pivotal role.

Sir Richard Leese, chair of the integrated care system, says the GM collaborative is likely to be assigned the bulk of the area’s acute care funding.

The joint body made up of local trusts, which is already operating in shadow form, would be able to receive and hold the funding as it would be a legal entity of the integrated care system.

He added: “There’s also a realistic recognition that this will probably lead to certainly the bulk of acute funding going to the provider collaborative for the next two to three years.

“Some of that resource will go direct to the providers — that’s got to be the case — but some of it will be held by the provider collaborative. The white paper does allow the ICS board to delegate to various NHS structures beneath it… and provider collaboratives are identified in the white paper.”

Handing a significant portion of the ICS’ funding to the collaborative could prove controversial among some in the region, however, as there have been calls for each borough to have full control over its own share of funding.

Reorganising the queue

People with learning disabilities are being prioritised for care at one acute trust, after analysis showed they were disproportionately affected by lengthy treatment waits.

Calderdale and Huddersfield Foundation Trust said it has initially prioritised people with learning disabilities after cancer and urgent patients, as it wants to manage waiting lists “around health inequalities and need”.

The decision was made as people with learning disabilities have shorter average life expectancies and therefore are disproportionately affected by long waits for care. 

It forms part of wider work the trust is doing around elective waiting lists and health inequalities. In further analysis, CHFT has found those who are poorer are waiting longer for care. HSJ has been told findings from this work have been circulated throughout the North East region. However, the trust does not yet want to share this publicly.